Rural Health Improvement Act of 1996

TABLE OF CONTENTS:

Title I: Equalization of Medicare Reimbursement Rates to

Health Maintenance Organizations and Competitive Medical

Plans

Title II: Grants to Encourage Establishment of Community

Rural Health Networks

Title III: Medicare Rural Primary Care Hospitals and Rural

Emergency Access Care Hospitals

Subtitle A: Rural Primary Care Hospital Program

Subtitle B: Rural Emergency Access Care Hospitals

Title IV: Incentives for Health Professionals to Practice in

Rural Areas

Subtitle A: National Health Service Corps

Subtitle B: Primary Care Services Furnished in Shortage

Areas

Title V: Classification of Rural Referral Centers

Title VI: Promotion of Health Centers in Rural Regions

Title VII: Medicare Payment Methodologies

Title VIII: Antitrust

Title IX: Financing

Rural Health Improvement Act of 1996 - Expresses the sense of the Congress that this Act reflects the dedication of the late U.S. Representative Bill Emerson to ensuring health care access for all rural Americans.

Title I: Equalization of Medicare Reimbursement Rates to Health Maintenance Organizations and Competitive Medical Plans - Amends title XVIII (Medicare) of the Social Security Act (SSA) to revise provisions for payments to health maintenance organizations (HMOs) and competitive medical plans (CMPs) for the stated purpose of equalizing Medicare reimbursement rates to HMOs and CMPs.

Title II: Grants to Encourage Establishment of Community Rural Health Networks - Directs the Secretary of Health and Human Services (HHS) to provide grants over a three year period to eligible States for development of plans to increase access to health care services for residents of areas in the State that are designated as chronically underserved. Authorizes appropriations.

(Sec. 202) Directs the HHS Secretary to make funds available to provide technical assistance and advice for certain entities seeking to establish or enhance a community rural health network in an underserved rural area. Authorizes appropriations.

(Sec. 203) Directs the HHS Secretary to provide financial assistance (development grants) to eligible entities for the development and implementation of community rural health networks, giving priority to eligible entities in States with developed plans to increase the access of residents of chronically underserved areas to health care services. Authorizes appropriations.

(Sec. 205) Ends Federal financing for the grant program for rural health transition under the Omnibus Budget Reconciliation Act of 1987 and a certain program for rural outreach grants.

Title III: Medicare Rural Primary Care Hospitals and Rural Emergency Access Care Hospitals - Subtitle A: Rural Primary Care Hospital Program - Replaces the Essential Access Community Hospital Program (EACH) under Medicare with the Medicare Rural Primary Care Hospital Program, while continuing payment to designated EACHs. Bases payment for inpatient and outpatient rural primary care hospital services on the reasonable costs of the hospital in providing such services. Lengthens from 72 to 96 hours the maximum period of permitted inpatient stay at a rural primary care hospital.

Subtitle B: Rural Emergency Access Care Hospitals - Provides for a new Medicare Rural Emergency Access Care Hospital program, detailing coverage and payment for services.

Title IV: Incentives for Health Professionals to Practice in Rural Areas - Subtitle A: National Health Service Corps - Amends the Internal Revenue Code to exclude qualified National Health Service Corps scholarship payments and loan repayments from gross income.

(Sec. 402) Requires the HHS Secretary to study and report to the Congress on the allocation of Corps members among shortage areas.

(Sec. 403) Amends the Public Health Service Act to require the Secretary to give special priority to applications by community rural health networks for the assignment of Corps personnel for providing health services in or to a health professional shortage area.

Subtitle B: Primary Care Services Furnished in Shortage Areas - Amends SSA title XVIII to provide for an increase in the amount of additional Medicare payments for primary care services (currently, physicians' services) furnished in rural shortage areas, and for services that are furnished by a physician assistant, nurse practitioner, or nurse midwife that would be physicians' services if furnished by a physician. Extends such payment for former shortage areas. Requires carriers to report on services provided.

Title V: Classification of Rural Referral Centers - Amends SSA title XVIII to prohibit denial of a rural referral center's request for reclassification on the basis of comparability of wages. Provides for the continuing treatment of previously designated rural referral centers.

Title VI: Promotion of Health Centers in Rural Regions - Amends the Public Health Service Act to require the HHS Secretary, in making grants in rural areas for new or expanded services for each fiscal year, to give priority to projects that would be located in a State, or county or region of a State, that is not already serviced by an existing community health center. Requires also the Secretary to give special consideration to projects which have entered into a collaborative agreement with a community hospital meeting certain requirements.

Title VII: Medicare Payment Methodologies - Directs the HHS Secretary to establish a methodology for making payments under Medicare part B (Supplementary Medical Insurance) for telemedicine services furnished on an emergency basis to rural residents.

Title VIII: Antitrust - Expresses the sense of the Congress that: (1) the Federal Trade Commission, in conjunction with the Department of Justice, give special consideration to antitrust guidelines affecting physician and hospital networks located in rural areas during its ongoing review of such guidelines; and (2) the completion of the Commission's review be expedited to provide relief and clarification to physicians and hospitals working to develop alternative means of providing accessible, affordable, and quality health care services to all Americans, especially those living and working in rural areas.

Title IX: Financing - Revises Medicare secondary payer requirements. Makes permanent the requirements for: (1) employer responses to fiscal intermediary or carrier inquiries about the coverage of an employee or employee's spouse under a group health plan of the employer; and (2) the prohibition against a large group health plan's taking into account that the employee or a dependent of the employee is entitled to Medicare or end stage renal disease benefits.